title: Accuracy of early burn depth assessment by laser Doppler imaging on different days post burn.
abstract: BACKGROUND
  Accurate diagnosis of burn depth is essential in selecting the most appropriate treatment. Early assessment of burn depth by clinical means only has been shown to be inaccurate, resulting in unnecessary operations or delay of grafting procedures. Laser Doppler imaging (LDI) was reported as an objective technique to determine the depth of a burn wound, but the accuracy on very early days post burn has never been investigated yet.
  
  
  METHODS
  In 40 patients with intermediate depth burns, we prospectively evaluated and compared the accuracy of the LDI measurements with the clinical assessments on days 0, 1, 3, 5, 8. Clinical evaluation of the depth of the burn was performed by two observers blinded to the LDI images. Accuracies were assessed by comparison with outcome: healing times longer than 21 days were considered to be equivalent to a biopsy finding of a deep dermal wound. Obviously superficial and full thickness wounds were excluded. LDI flux level was used for LDI prediction of outcome: less than 220PU to predict non-healing at day 21.
  
  
  RESULTS
  The accuracies of burn depth assessments on the day of burn and post burn days 0, 1, 3, 5 and 8 using LDI were 54%, 79.5%, 95%, 97% and 100% compared with clinical assessment accuracies of 40.6%, 61.5%, 52.5%, 71.4% and 100%, respectively. LDI accuracy was significantly higher than clinical accuracy on day 3 (p<0.001) and day 5 (p=0.005). Burn depth conversion was also considered. This is the first study to quantify the advantage of LDI scanning over clinical assessments during these important early after burn days.
authors.affiliation: Department of Plastic Surgery, Gent University Hospital, De Pintelaan 185, Gent, Belgium. henk.hoeksema@ugent.be
authors.forename: Henk
authors.initials: H
authors.lastname: Hoeksema
authors.forename: Karlien
authors.initials: K
authors.lastname: Van de Sijpe
authors.forename: Thiery
authors.initials: T
authors.lastname: Tondu
authors.forename: Moustapha
authors.initials: M
authors.lastname: Hamdi
authors.forename: Koenraad
authors.initials: K
authors.lastname: Van Landuyt
authors.forename: Phillip
authors.initials: P
authors.lastname: Blondeel
authors.forename: Stan
authors.initials: S
authors.lastname: Monstrey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002056:Burns / Q000473:pathology* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D017439:Cicatrix, Hypertrophic / Q000473:pathology* / Q000628:therapy; D005260:Female; D006801:Humans; D007834:Lasers; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012867:Skin / Q000473:pathology*; D016038:Skin Transplantation / Q000379:methods; D013997:Time Factors; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult